Provider Demographics
NPI:1205268117
Name:FC RANGER OPS NEAWANNA (OR), LLC
Entity type:Organization
Organization Name:FC RANGER OPS NEAWANNA (OR), LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:K
Authorized Official - Last Name:FIRTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-754-5586
Mailing Address - Street 1:20 N WAHANNA RD
Mailing Address - Street 2:
Mailing Address - City:SEASIDE
Mailing Address - State:OR
Mailing Address - Zip Code:97138-7862
Mailing Address - Country:US
Mailing Address - Phone:503-470-6215
Mailing Address - Fax:503-738-5569
Practice Address - Street 1:20 N WAHANNA RD
Practice Address - Street 2:
Practice Address - City:SEASIDE
Practice Address - State:OR
Practice Address - Zip Code:97138-7862
Practice Address - Country:US
Practice Address - Phone:503-470-6215
Practice Address - Fax:503-738-5569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility